A 70-year-old woman presents with a strangulated femoral hernia requiring emergency bowel resection. At surgery, which structure forms the medial boundary of the femoral canal (and is intentionally divided to enlarge the femoral ring during emergency repair)?

• A Inguinal ligament
• B Pectineal (Cooper's) ligament
• C Iliopectineal arch
• D Lacunar (Gimbernat's) ligament ✓

Explanation

The femoral canal boundaries: anteriorly — inguinal ligament; posteriorly — pectineal (Cooper's) ligament; laterally — femoral vein; medially — lacunar (Gimbernat's) ligament. The lacunar ligament is the medial boundary and is frequently divided ('incised') to enlarge the tight femoral ring during emergency decompression of a strangulated femoral hernia. A caution: an aberrant obturator artery ('corona mortis' variant) may pass behind the lacunar ligament, requiring careful incision.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.